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People who have Type 1 diabetes must use insulin to control their disease. Unlike Type 2 diabetes, which requires daily checks with glucose meters, type 1 patients can't simply rely on a diabetic diet, exercise, or even diabetes medications in pill form. In those with Type 1, the pancreas no longer makes insulin. Therefore, Type 1 diabetics require insulin that can be given with injections throughout the day or with an insulin pump.
Insulin pumps are a fairly new way to treat diabetes. Because glucose levels in Type 1 diabetes are so hard to regulate, an insulin pump delivers a much more controlled, continuous insulin treatment. There are many advantages to using an insulin pump, but it does take the patient some time to adjust.
What are Insulin Pumps?
An insulin pump has a pump reservoir (like the insulin cartridge that insulin pens use), a battery-operated pump, and a computer chip that allows the patient to control the exact amount of insulin being delivered to the body. Currently, pumps on the market are about the size of a pager. The pump is attached to a thin, plastic tube (the infusion set) that has a cannula (like a soft needle) at the end. The insulin passes through it. The cannula is inserted under the skin, usually around the abdomen and is changed every two days. The tubes can be disconnected from the pump when you shower.
The pump delivers insulin continuously 24 hours a day. The amount of insulin that you require is programmed like a computer and given at a constant rate. The amount you need can depend on things like your activity level or sleep. For example, the patient can program the pump to deliver more insulin during meals to cover the need for more insulin when you digest carbohydrates.
What's New in Insulin Pumps?
Exciting technology is constantly being developed to make the insulin pump even more effective. One innovation involves being able to use the pump together with newer glucose-sensing implantable sensors. The sensor communicates with a small device—the screen displays information about your glucose reading.
Getting Comfortable Using an Insulin Pump
Using a medical device that inserts under your skin may sound unpleasant. But after an adjustment period, which may take a couple of months, patients live very normal lives with their insulin pumps. Your diabetes doctor and treatment team will answer any questions about how to use your pump correctly. Some tips to remember about your insulin pump:
- If you travel, remember to bring extra supplies or at least an insulin pen if you are not able to use your pump
- When you take your insulin pump off or turn it off, work out a way to remind yourself to turn it back on
- Make a habit of recording all your glucose level checks and other information about carbohydrates, etc
Remember there a lot of advantages to using an insulin pump over pen or other injections.
- The pump delivers insulin more accurately than injections
- The pump makes managing your diabetes much easier
- The pump allows you to be more flexible about what and when you eat
Does Medicare Cover Insulin Pumps?
Insulin pumps are considered "Durable Medical Equipment," which is medical equipment ordered by your doctor for use in the home. If you have a prescription from you doctor, Medicare may cover insulin and insulin pumps for people with Medicare Part B who have:
- Type 1 insulin-dependent diabetes, or
- Type 2 insulin-dependent diabetes with glucose that is difficult to control, or
- Gestational diabetes with glucose that is difficult to control
You are responsible for paying 20 percent of the Medicare-approved amount and the Original Medicare Part B deductible applies. You should work with your doctor and healthcare providers to determine if an insulin pump is right for your diabetes treatment.
Important Note: As of January 2011, Medicare has been phasing in a new program for Durable Medical Equipment called "competitive bidding" to help save you and Medicare money and ensure that you get quality equipment, supplies, and services. Under this new rule, you must use specific suppliers in some areas of the country, or Medicare will not pay for the item.
This rule is currently effective in several metropolitan areas in the following states: CA, FL, IN, KS, KY, MO, NC, OH, PA, SC, and TX. If you live in one these areas—or get the items while visiting one of these areas—you will have to use a supplier that participates in the competitive bidding program. Beginning in 2012, the program is scheduled to expand to an additional 91 metropolitan areas, and by 2016, it will be effective in regions in all 50 states. It's important to know that mail-order diabetes supplies come under this new rule.